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The educational attainment of Aboriginal and Torres Strait Islander students is often presented within a deficit view. The need for Aboriginal and Torres Strait Islander researchers to challenge the societal norms is necessary to contribute to the struggle for self-determination. This paper presents a theoretical and methodological approach that has enabled one researcher to speak back to the deficit discourses. Exemplification of how Indigenous Critical Discourse Analysis (in: Hogarth, "Addressing the rights of Indigenous peoples' in education: A critical analysis of Indigenous education policy," Queensland University of Technology, Brisbane, 2016) identifies the power of language to maintain the inequitable positioning of Aboriginal and Torres Strait Islander peoples within Australian society is provided. Particular focus is placed on the Aboriginal and Torres Strait Islander Education Action Plan 2010-2014 (in: MCEECDYA, "Aboriginal and Torres Strait Islander Education Action Plan (2010-2014)," 2011) and how policy discourses ignore the historical, political, cultural and social factors that influence the engagement and participation of Indigenous peoples in education today. The paper argues for the need to personalise methodological approaches to present the standpoint of the researcher and, in turn, deepens their advocacy for addressing the phenomenon. In turn, the paper presents the need to build on existing Indigenous research frameworks to continue advocating for the position of Indigenous research methodologies within the Western institution.

The principles of social inclusion have been embraced by institutions across the higher education sector but their translation into practice through pedagogy is not readily apparent. This paper examines perceptions of social inclusion and inclusive pedagogies held by academic staff at an Australian university. Of specific interest were the perceptions of teaching staff with regard to diverse student populations, particularly students from low socio-economic (LSES) backgrounds, given the institution's reasonably high proportion of LSES student enrolment (14%). A mixed-method approach was utilised: (i) in-depth interviews with a representative sample of academic staff and (ii) an online survey targeting all academic staff across the institution. The results point to the dual responsibilities of students and institutions in enacting inclusivity in order to move beyond reductive standpoints that simply apportion blame.

Classroom observations are sometimes a challenging form of data collection. Not only are interpretations of those observations subject to the researcher's theoretical lens, but communication between the researcher and the teacher is often delayed until well after the observed events. This article reports research that focused on the pedagogical decision-making of a teacher in an English classroom, with the aim of understanding how the teacher catered for "new" students. Initially, video-stimulated recall was identified as a possible way of assisting a review of classroom practices and considering reflections "on action". However, the teacher instigated an "in action" method of data collection by conducting two conversations at once in her classroom. One conversation was her teaching, comprising interactions with the students in her class; the other conversation was a "voice-over", to alert the researcher to what she was doing and why. This teacher-developed strategy helped to make visible the teacher's thinking and justifications for particular classroom practices.

This research aims to identify ageist content concerning older adults within local government physical activity policy. Policies are not passive texts; they can comprise hidden or disputed connotations. To identify ageism, the study utilizes a critical discourse analysis approach to analyze physical activity policy documents (n = 61) from 16 local government areas in Victoria, Australia, and the perceptions of local government employees trusted with developing these policies, which were gathered during semistructured interviews (n = 11). Results from the critical discourse analysis indicate that local government policies are imbued with ageism, leading to the construction and perpetuation of various stereotypes of older adults. The discourse analysis points to potentially ageist descriptions including older adults being vulnerable, incapable, and a financial burden. Nonetheless, older adults were also revealed to be significant contributors to the community including in paid employment, caregiving roles, and volunteering. [ABSTRACT FROM AUTHOR]

Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions. [ABSTRACT FROM AUTHOR]

Objective Physical therapy is generally considered to be a white profession in Western nations. Australia's increasingly diverse population, driven largely by growth in immigration, invites Australian health systems to be responsive to factors that may impact on non-white Australian population's access to health care. Here, the authors sought to explore non-Indigenous Black people's perspectives of physical therapy in Australia. Methods Eligible participants (n  = 12) took part in semistructured, in-depth interviews and were prompted to discuss their experiences and perceptions of physical therapy. Interview data were analyzed using critical discourse analysis, underpinned by critical race theory. Results Participants were on average 29.4 years (SD = 12.9) from diverse cultural and linguistic backgrounds. Participants described mostly positive experiences with physical therapists, but they noted that it was not widely accessed by their communities, with 2 key discourses underpinning these discussions. Discourse 1, "physiotherapy is a solution for white people," established physical therapy as primarily accessed by and welcoming of white people. "Whiteness" and the perpetuation of Western norms in physical therapy resulted in little consideration of other cultural practices. Participants' discussions also pointed to the intersections of systemic racism and social inequities such as low income and language barriers, impacting Black people's engagement with physical therapy. Discourse 2, "physiotherapists are white," was mostly concerned with how the perceived "whiteness" of professionals and lack of Black physical therapists impacts cultural safety and comfort when accessing physical therapy. Conclusion Our results suggest that Westernization and whiteness persist among discourses surrounding physical therapy. Such discourses are likely to inform Black people's perceptions and experiences of physical therapy. Our analyses suggest avenues to enhance the cultural diversity of the profession and improve physical therapy accessibility for Black people in Australia by providing culturally appropriate material, including critical reflexivity, epistemic and cultural humility in the curricula, recruiting staff from diverse backgrounds, and providing outreach services to underserved populations. Impact These findings highlight the need for increased cultural safety and diversity within the physical therapy profession to improve equity. [ABSTRACT FROM AUTHOR]

Current legal discourse puts forward socio-legal collaborations, integrated social work and legal practice and medical/legal partnerships as innovations from the legal sector aimed at resolving clients' intertwined legal and social issues. In doing so it has generalised and diminished the specific contribution in these programmes of highly skilled social work staff. This article sets out a study of Australian socio-legal collaborations to re-establish the significant contribution made by social workers in this sector. It argues that social workers are the dominant social service profession and provide integral practice and leadership contributions. It argues that further research in Australia and internationally is required to support social work to stand in leadership alongside lawyers, not only in these programmes but also in the discourse and sector that surrounds them. [ABSTRACT FROM AUTHOR]

Negative, ableist discourse challenging the rights of people with Down syndrome to receive support services and even to be born regularly arise on social media. This disability community has retaliated against such hate speech with resistance narratives that promote the value of people with Down syndrome, with few other recourses available. This article explores online free speech versus ableism in Australia through a major case study of 60 Minutes Australia Facebook discussions. Analysis identifies types of ableism expressed, types of harm caused and dimensions of grassroots responses. Using Timothy Garton Ash's 2016 work Free Speech as a basis for contemporary analysis, we discuss: to what extent should harmful and offensive comments directed at vulnerable populations be tolerated in the name of free speech; might negative, ableist discourse contribute to any social good; and what mechanisms beyond grassroots resistance narratives might effectively respond to harmful, online ableist discourses. The article looks at whether the right to free speech is more important than the harmful effects of online hate speech towards people with Down syndrome. We use the ideas in a book on Free Speech by Timothy Garton Ash to think about whether online hate speech should be allowed or silenced. Our analysis is based on a case study of Facebook discussion threads from a 60 Minutes Australia television segment. People in the disability community speaking up to create resistance narratives is the main way that online disability hate speech is challenged. Other ways that could help are laws, government agencies providing support materials, and social media rules. [ABSTRACT FROM AUTHOR]

Global awareness about an increase of chronic diseases and premature mortality due to 'unhealthy eating' and 'sedentary lifestyles' is embedded in various discourses shaped by relationships and power. In this article, I investigate the role of physical activity in the lives of middle-aged women in Australia and how their experiences with exercise influence the way they position themselves within the context of inter-discursivity regarding fitness and 'healthy ageing'. Results reveal how 'knowledge' about 'healthy lifestyles' is created and accessed, and how women make sense of the healthism discourse, the obesity crisis, and discourses around menopause and ageing. The participants for this study are nine women in their forties to sixties who volunteered to participate in semi-structured interviews after completing an online survey about physical activity that was part of a larger project. Their accounts of health and fitness, healthy eating, weight management, mental wellbeing and ageing are categorised and interpreted in a post-structuralist framework through the lens of feminist relational discourse analysis. Results show that all women are influenced by healthism discourses as well as being affected by assumptions and recommendations for ageing, menopausal women. They shape female identity by adopting, but also by resisting, discourses around their bodies and minds. [ABSTRACT FROM AUTHOR]

Background: An epidemic of type 2 diabetes in remote Aboriginal people in Central Australia, contributes to high rates of morbidity and mortality. Remote non-Aboriginal Health Care Workers (HCW) and the Aboriginal people they serve inhabit a complex cultural interface. This study aimed to recognise racial microaggressions in the everyday discourse of HCWs. It proposes a model of interculturality for remote HCWs that avoids racialisation and essentialising of Aboriginal people's identities and cultures. Methods: Semi-structured in-depth interviews were undertaken with HCWs from two Primary Health Care services in very remote Central Australia. Fourteen interviews were analysed from seven Remote Area Nurse, five Remote Medical Practitioners and two Aboriginal Health Practitioners. Discourse analysis was employed to explore racial microaggressions and power relations. NVivo software assisted in the thematic organisation of microaggressions according to a predefined taxonomy. Results: Seven microaggression themes were identified - racial categorization and sameness, assumptions about intelligence and competence, false colour blindness, criminality and dangerousness, reverse racism and hostility, treatment as second-class citizens and pathologizing culture. A model of interculturality for remote HCWs was based on concepts of the third space, deCentred hybrid identities and small culture formation on-the-go combined with a duty-conscious ethic, cultural safety and humility. Conclusions: Racial microaggressions are common in the discourse of remote HCWs. The model of interculturality proposed could improve intercultural communication and relationships between HCWs and Aboriginal people. This improved engagement is required to address the current diabetes epidemic in Central Australia. [ABSTRACT FROM AUTHOR]

Background: Communication about managing medications during transitions of care can be a challenging process for older patients since they often have complex medication regimens. Previous studies highlighted that links between communication breakdowns and medication incidents in older patients occur mainly at discharge or in the post‐discharge period. Little attention has been paid to exploring communication strategies facilitating patient‐centred medication communication at transitions of care from a discourse‐analytic perspective. Objectives: To explore, through a discursive lens, strategies that enable patient‐centred medication communication at transitions of care. Design: A focused ethnographic study was employed for this study. The study was reported according to the COREQ checklist. Methods: Interviews, observations and focus groups were analysed utilising Critical Discourse Analysis and the Medication Communication Model following thematic analysis. Data collection was undertaken in eight wards across two metropolitan hospitals in Australia. Results: Patient preferences and beliefs about medications were identified as important characteristics of patient‐centred communication. Strategies included empathetic talk prioritising patients' medication needs and preferences for medications; informative talk clarifying patients' concerns; and encouraging talk for enhancing shared decision‐making with older patients. Challenges relating to the use of these strategies included patients' hearing, speech or cognitive impairments, language barriers and absence of interpreters or family members during care transitions. Relevance to clinical practice: To enhance medication communication, nurses, doctors and pharmacists should incorporate older patients' preferences, previous experiences and beliefs, and consider the challenges faced by patients across transitions. Strategies encouraging patients' contribution to decision‐making processes are crucial to patient‐centeredness in medication communication. Nurses need to engage in informative talk more frequently when administering the medications to ensure older patients' understanding of medications prescribed or altered in hospital settings. [ABSTRACT FROM AUTHOR]

Background: Communicating about medications across transitions of care is important in older patients who frequently move between health care settings. While there is increasing interest in understanding patient communication across transitions of care, little is known about older patients' involvement in formal and informal modes of communication regarding managing medications. Objective: The aim of this paper was to explore how older patients participated in managing their medications across transitions of care through formal and informal modes of communication. Methods: The study was conducted across two metropolitan hospitals: an acute hospital and a geriatric rehabilitation hospital in metropolitan Melbourne, Australia. A focused ethnographic design was used involving semi‐structured interviews (n = 50), observations (203 h) and individual interviews or focus groups (n = 25). Following thematic analysis, data were analysed using Fairclough's Critical Discourse Analysis. Results: Data analysis revealed two major discursive practices, which comprised of an interplay between formal and informal communication and environmental influences on formal and informal communication. Self‐created patient notes were used by older patients to initiate informal discussion with health professionals about medication decisions, which challenged traditional unequal power relations between health professionals and patients. Formal prompts on electronic medication administration records facilitated the continuous information discourse about patients' medications across transitions of care and encouraged health professionals to seek out older patients' preferences through informal bedside interactions. Environmental influences on communication comprised health professionals' physical movements across private and public spaces in the ward, their distance from older patients at the bedside and utilization of the computer systems during patient encounters. Conclusion: Older patients' self‐created medication notes enabled them to take on a more active role in formal and informal medication communication across transitions of care. Older patients and family members did not have continuous access to information about medication changes during their hospital stay and systems often failed to address older patients' key concerns about their medications, which hindered their active involvement in formal and informal communication. Patient or Public Contribution: Older adults, family members and health professionals volunteered to be interviewed and observed. [ABSTRACT FROM AUTHOR]

Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals – as holders of organisational power – and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of 'other' cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support. [ABSTRACT FROM AUTHOR]

Research Objective: The aim of this article is to report a study that explores how spirituality is understood to be represented in the current Australian Nursing and Midwifery Board of Australia (NMBA) Registered Nurse (RN) standards for practice. Research Design: Fairclough's approach to critical discourse analysis was applied in the examination of participant interview texts for the language used in relation to spirituality as well as power mechanisms which influenced the way the participants viewed spirituality's representation in the RN Standards for Practice. Participants: Three members of the RN Standards for Practice research and development team. Results: Findings indicate three discourses shaped the way participants viewed how spirituality is presently represented in the RN Standards for Practice. Discourses are (1) spirituality as part of holistic care, (2) spirituality as part of person-centered care, and (3) the professionalization of nursing. Conclusions: Participant interviews revealed these discourses exerted power over how spirituality was represented within the RN Standards for Practice. This has implications for the inclusion of spirituality in the practice standards and the practice of spiritual care. [ABSTRACT FROM AUTHOR]

Communicating about medications across transitions of care is a challenging process for older patients. In this article, we examined communication processes between older patients, family members, and health professionals about managing medications across transitions of care, focusing on older patients' experiences. A focused ethnographic design was employed across two metropolitan hospitals. Data collection methods included interviews, observations, and focus groups. Following thematic analysis, data were analyzed using Fairclough's Critical Discourse Analysis and Medication Communication Model. Older patients' medication knowledge and family members' advocacy challenged unequal power relations between clinicians and patients and families. Doctors' use of authoritative discourse impeded older patients' participation in the medication communication. Older patients perceived that nurses' involvement in medication communication was limited due to their task-related routines. To reduce the unequal power relations, health professionals should be more proactive in sharing information about medications with older patients across transitions of care. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate ways in which interpreting practice in health care settings can be further developed to better facilitate communication with Aboriginal and Torres Strait Islander patients. Data used include 15 hours of transcribed audio recording from semi-structured interviews with interpreters and Aboriginal Liaison Officers who discuss their perceived experiences of interpreting in medical settings. They offer insights into how language is used to resolve communication differences that may confound the interpreting process and in doing so identify roles interpreters assume and discourse patterns that emerge in interpreting practice. As evidenced through the findings, provisions need to be made for cultural differences. Interpreters report they have to "unpack" medical terminology and explain such terminology and related concepts in tangible terms to ensure patient understanding. Other strategies include talking about taboo topics using culturally appropriate terms, avoiding certain question–answer routines, and being aware of nonverbal aspects of communication. [ABSTRACT FROM AUTHOR]

This research aimed to understand how the policy was represented as a 'problem' in food regulatory decision-making in Australia, and the implications for public health nutrition engagement with policy development processes. Bacchi's 'what's the problem represented to be?' discourse analysis method was applied to a case study of voluntary food fortification policy (VFP) developed by the then Australia and New Zealand Food Regulation Ministerial Council (ANZFRMC) between 2002 and 2012. As a consultative process is a legislated aspect of food regulatory policy development in Australia, written stakeholder submissions contributed most of the key documents ascertained as relevant to the case. Four major categories of stakeholder were identified in the data; citizen, public health, government and industry. Predictably, citizen, government and public health stakeholders primarily represented voluntary food fortification (VF) as a problem of public health, while industry stakeholders represented it as a problem of commercial benefit. This reflected expected differences regarding decision-making control and power over regulatory activity. However, at both the outset and conclusion of the policy process, the ANZFRMC represented the problem of VF as commercial benefit, suggesting that in this case, a period of 'formal' stakeholder consultation did not alter the outcome. This research indicates that in VFP, the policy debate was fought and won at the initial framing of the problem in the earliest stages of the policy process. Consequently, if public health nutritionists leave their participation in the process until formal consultation stages, the opportunity to influence policy may already be lost. [ABSTRACT FROM AUTHOR]

This study explored how psychologists and psychiatrists working in Australian youth mental health services constructed their professional identity, and whether and how implementing Open Dialogue transformed this. Nine clinicians (psychologists, clinical psychologists and psychiatrists) were interviewed after completing Open Dialogue training. Interviews were subjected to discourse analysis. First, two general pre‐existing discursive professional identity positions were constructed: (i) psychiatrists rhetorically distancing themselves from the medical model as 'fixers' of mental illness; and (ii) psychologists and psychiatrists rhetorically embracing their personal identity. Second, participants' responses about implementing Open Dialogue revealed opportunities and discomforts, including: (i) dialogical approaches offering psychiatrists an alternative identity to 'fixers'; and (ii) dialogical approaches generating discomfort at the risk of exposing participants' own vulnerability. Participants' professional identities comprised contrasting positions. Practitioner points: Clinicians' professional identities comprised contrasting positionsClinicians constructed their professional identities by othering themselves from perceived dominant professional paradigmsClinicians incorporated dialogical approaches into existing clinical work after being exposed to Open DialogueClinicians identified Open Dialogue as offering opportunities to construct alternative professional identitiesClinicians appeared uncomfortable with dialogical approaches in situations of high risk within risk‐averse settings [ABSTRACT FROM AUTHOR]

Aim and objective: To explore and establish the language, clinical opinions and workplace culture around neonatal skin injury nomenclature. Specifically, what nomenclature is used to describe, define, identity and communicate neonatal skin injuries including (a) terms, (b) locations, (c) associated risks and (d) mechanical forces. Background: Skin injuries are affirmed or denied based on visual assessment with findings reported by language rather than measurements. However, if language or nomenclature is ambiguous, assessments could be misinterpreted effecting healthcare delivery. Design: Qualitative enquiry including applied discourse analysis and between‐method triangulation, within a larger exploratory mixed‐methods study. Methods: Data were collected over two years from four sources: literature, documents, interviews/focus groups and free text injury assessments. Data analysis included content analysis, selective coding and thematic analysis. The collective data were further explored using discourse analysis and triangulation to achieve collective conclusions about opinions, emotions, feelings, perceptions and workplace cultures. The COREQ checklist provided structure for the reporting of study methods, analysis and findings. Results: A total of 427 data points were collected from literature, documentation and two clinical data sources. Data convergence revealed that neonatal skin injuries are described by numerous terms with preferences for "injury," "trauma" or "redness." Injuries occur in over 20 anatomical locations and risks for injuries included hospitalisation, specific treatments and prematurity. Essential medical devices, clinical condition, lack of clinician experience and overactive neonates were uniquely associated risks. There was incongruency between sources. The literature and documents empathise pressure as the primary force related to skin injury, while varied forces were identified within interviews, focus groups and free text injury assessments. Conclusions: The variety of unique terms, locations and risks for injury indicate the need for updated neonatal skin injury frameworks. If frameworks and policies continue to be created without the empirical knowledge of neonatal clinicians, misrepresentation of neonatal skin injury locations and risk will continue to dominate the literature. Relevance to Clinical Practice: The recognition and management of neonatal skin injuries are related to language used to describe assessments in the absence of diagnostic confirmation, which has implications for both the neonate and the healthcare team. [ABSTRACT FROM AUTHOR]

Goals of the mental health consumer movement include redressing inequality and increasing consumer leadership across the mental health sector. A means of achieving these goals is empowerment of consumers at systemic levels of the mental health sector. There have been calls for research to focus on allies – those who use their power to support and advocate for the goals of the consumer movement. This study aimed to examine the role of allies in consumer empowerment. Semi‐structured interviews were conducted with 15 individuals (including three consumers, nine allies, and three participants each identifying as both consumer and ally). Findings suggest that allies cannot directly empower consumers but should support opportunities for consumer leadership within the sector. We discuss how allies might do this and avoid paternalism in their allyship. [ABSTRACT FROM AUTHOR]

In this study, adult migrant and refugee women's negotiation of sexual agency in the context of marriage is explored. In Sydney, Australia and Vancouver, Canada, 78 semistructured individual interviews, and 15 focus groups, comprised of 82 participants, were conducted with women who had recently migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. Women's negotiation of sexual agency was evident with respect to husband choice, disclosure of sexual desire, pleasure, pain, and sexual consent. While some participants took up subjugated sexual subject positions reflecting dominant cultural or religious discourses, many women also resisted these discourses to enact sexual agency. [ABSTRACT FROM AUTHOR]

Objective: This study has two interconnected aims. The first was to better understand how audiology students co-construct hearing assessments with patients while supervised by a clinical educator. The second was to investigate how students' communication aligns with principles of patient-centred communication. Study Sample: Twenty-three final year audiology students from two Australian universities participated in the study. Results: The supervised student-patient hearing appointments were video-recorded and transcribed. Genre analysis, a form of discourse analysis, was carried out to identify the structure and communication patterns. The six-function model of medical communication was adopted as an analytical framework to map students' patient-centred communication. The findings showed generic structure of the hearing assessments were the main stages of taking a history, providing a diagnosis, and initiating management plans. For patient-centred communication functions, students demonstrated their ability to foster the relationship and gather information. The communication functions of decision-making, enablement, and responding to patients' emotions were rarely observed. A significant relationship was found between clinical educators' interjection as a function of students' patient-centred communication tendencies. Conclusion: To enhance students' patient-centred communication, teaching should include explaining and planning as well as addressing additional aspects of patient-centred communication. Support of clinical educators is needed to optimise students' communication skills learning. [ABSTRACT FROM AUTHOR]

Purpose Evidence from Australia and worldwide has highlighted the ongoing marginalisation, discrimination, abuse, violence and neglect of people with disability. One of the main areas of concern is that despite such evidence there remain fundamental barriers for people with disability to report violence and/or access supports. Significantly few studies have canvased the perspectives of people with intellectual disability (ID), family members or disability service providers. Accordingly as a first step, the purpose of this paper is to explore the perceptions of disability and violence-response professionals’ regarding the barriers and facilitators of effective support for people with ID reporting sexual violence and accessing mainstream supports.Design/methodology/approach A qualitative research design informed the basis of this study. Semi-structured interviews were conducted with seven participants who held roles within disability services and mainstream violence response. Interviews were recorded and transcribed. These transcripts were then analysed individually using a combination of thematic analysis and discourse analysis to bring to light the social and material structures within service systems in terms of how they disempower or empower supports for people with ID.Findings Participants from both services reported that professionals (particularly those outside the disability sector) lacked awareness of practical ways in which they could support people with ID to report and access services outside of disability-specific services. Participants also felt the capacity for people with ID to have a voice about what happens in the “aftermath” of reporting sexual violence was rarely acknowledged. Participants called for education and development of resources which could guide professional practice across disability and wider violence-response services. Participants saw investment in building interagency relationships across sectors as key to supporting the citizenship of people with ID.Originality/value This study suggests that there is a strong need for better community engagement and understanding of the multi-faceted issues surrounding responses to violence concerning people with ID. The findings of this study also outline implications for practice and policy which may be of interest to professionals both within disability and wider violence-response sectors in Australia and internationally. [ABSTRACT FROM AUTHOR]

In this article, we explore how young women encounter and counter discourses of smoking-related stigma. Twenty-seven young Australian women, smokers and ex-smokers, took part in interviews. A sub-sample of 18 participants took photographs to document their smoking experience, and took part in a second interview. Data were analyzed through Foucauldian discourse analysis. Four discourses were identified: “smoking as stigmatized,” “the smoking double standard,” “smoking as lower class,” and “smokers as bad mothers.” The women negotiated stigma in a variety of ways, shifting between agreeing, disagreeing, challenging, and displacing stigma onto “other” smokers. These experiences and negotiations of smoking-related stigma were shaped by intersecting identities, including gender, cultural background, social class, and mothering, which at times, compounded levels of stigmatization. It is concluded that tobacco control measures should consider the negative implications of smoking-related stigma, and the potential for women to experience compounding levels of stigma. [ABSTRACT FROM AUTHOR]

Bulimia, an eating disorder that affects more women than men, involves binging and compensatory behaviors. Given the importance of food in experiences of these behaviors, in this article, we examine constructions of food in accounts of bulimic behavior: how these constructions relate to cultural discourses, and their implications for subjectivity. Fifteen women who engaged in bulimic behaviors were interviewed. Through a thematic decomposition of their accounts, we identified six discursive constructions of food: “good/healthy” or “bad/unhealthy,” “contaminating body and soul,” “collapsed into fat,” “pleasurable reward,” “comfort,” and “fuel for the body.” Many constructions were consolidated through participants’ embodied experiences, but made available through discourses in public health, biomedicine, and femininity, and had implications for subjectivity in terms of morality, spirituality, and self-worth. Thus, despite women deploying these constructions to make sense of their bulimic behaviors, they are culturally normative; this point has implications for therapeutic and preventive strategies for bulimia. [ABSTRACT FROM AUTHOR]

In this article, we examine how young women make sense of the risks associated with smoking cigarettes. We recruited young women smokers and ex-smokers living in Australia in 2014 and 2015 to participate in semi-structured interviews and a participant-produced photography activity on young women’s experiences of smoking and smoking-related risk. We analysed the data using discourse analysis to examine how young women positioned themselves in relation to smoking-related risk, and how this was shaped by discourses of health, risk and femininity. We identified four dominant interpretative repertoires: ‘the risks of smoking are self-evident’, ‘it’s not going to happen to me’, ‘smoking as a lesser evil’ and ‘smoking to cope with stress and emotion’. Through our analysis, we found that by drawing on these repertoires, participants were able to position the risks of smoking as both acceptable and unacceptable. Participants also made use of several of these repertoires to position anti-smoking messages as ineffective. We place these findings in the context of broader health and risk discourses surrounding young women’s use of smoking to reinforce and subvert representations of ‘respectable’ femininity. We identify ways in which public health approaches could and should be developed to recognise the complexity and contradiction inherent in young women’s lay accounts of smoking-related risk and situate smoking risks in the context of young women’s everyday lives. [ABSTRACT FROM PUBLISHER]

Nursing students are not always well prepared for the kind of adverse events they may experience in the workplace and yet it seems apparent that future students could benefit from learning about such experiences so that they can be avoided, or their impact minimised. This research aimed to identify nursing students' experiences of adversity, collaborate with students to discern important lessons for future students in their experiences, and make recommendations for other educators on how to use these adversity stories as lessons. Seven Australian nursing students were interviewed using critical incident technique consisting of 7 questions. This paper focuses on the responses to the questions: “Does this story's message have a place in the curriculum?” and “How would you teach this lesson?” Data were analysed using critical discourse analysis. Four recurring discourses emerged including: power relationships are a two-way street; learn from mistakes to prevent mistakes; begin cultural consciousness-raising in first year, first semester; and become critically self-aware. Narratives derived from original stories of adversity may be a valuable source of learning about the realities of the workplace but to benefit fully, educators need to assist students to notice and analyse embedded messages. [ABSTRACT FROM AUTHOR]

Primary objective: There have been few reports of the approaches taken by speech-language pathologists (SLPs) when assessing cognitive communication (CC) during post-traumatic amnesia (PTA) after TBI. This study sought to understand SLPs’ rationales for CC assessment during PTA and to examine their perspectives on assessment methods during the early recovery period. Methods and procedures: In this qualitative study, 10 SLPs participated in semi-structured face-to-face or telephone interviews about their rationales and methods for CC assessment during PTA and early recovery. Content analysis was conducted using NVivo software to identify key categories. Main outcome and results: SLPs reported their reasons for CC assessment as including: (1) Documenting changes and monitoring progress, (2) Feedback to team, family and patient, (3) Diagnosis of communication disorder, (4) Planning and (5) Prognosis. They described conducting ongoing, informal assessment and monitoring of CC, using a combination of standardized and non-standardized measures during PTA, and commenced formal testing after PTA resolution to formulate a baseline level of communication function. Conclusions: The current study highlighted the importance that SLPs placed on an individualized approach in CC assessment. Findings provided insight into the process of assessment of CC during PTA and the early stage of recovery after TBI. [ABSTRACT FROM PUBLISHER]

Within the context of global debates about safety and ethics of supporting women to give birth at home, it is important to analyse documents governing midwifery and obstetric practice and influence decision‐making around place of birth. In Australia, the United States and the United Kingdom, relatively small numbers of women choose to give birth at home despite their midwifery colleges' support. In the United States and Australia, the obstetric colleges do not support homebirth and these countries have lower numbers of women who birth at home, compared with the United Kingdom. There are numerous regulatory and industry challenges for midwives attending homebirths. This paper reports on a Foucauldian analysis of Australian obstetric and midwifery colleges' position statements about homebirth, who have conflicting views, with the view to understanding their arguments and underlying assumptions. The documents highlighted tensions between competing discourses of risk and autonomy and differences in academic argument. Opportunities for strengthening their statements are highlighted. The methodology is applicable for future analysis of similar documents governing practice in other countries. [ABSTRACT FROM AUTHOR]

Construction of adult life course and identity has typically been built around norms of partnering and parenting, placing single women who do not have children outside the norm. Studies undertaken with single women have found that relationship status was a key factor in their identity construction. In this study, we conducted semi-structured interviews with five single women without children living in Australia. Drawing on critical discursive psychology, we found that participants negotiated two contesting discourses to construct their identities: the Heterosexual Relationship and Family Life discourse and the Independent Single Woman discourse. In crafting identities, tensions were identified between the positioning of self and the positioning of self by others, particularly with respect to the Heterosexual Relationship and Family Life discourse. This was evident in some women contesting the positions afforded by the discourse, instead drawing on an asset identity. This asset identity enabled the women to pursue positive life opportunities. [ABSTRACT FROM PUBLISHER]

There are a limited number of dominant discourses available to frame drug use within Australia. These dominant discourses play an important role in policy debate and development, and also drug use behaviour. We describe the development of a psychometric instrument that is hypothesised to measure the degree to which individuals internalise dominant drug discourses. Sixty items were developed to reflect six dominant discourses of drug use. A substantive validity analysis was conducted. The highest loading items were included in a 27-item measure that was administered to 370 people seeking substance use treatment in Perth, Western Australia. In addition, participants completed the Locus of Control of Behaviour Scale. Confirmatory Factor Analysis tested the fit of a predicted six factor model, in addition to three other plausible models. The best fitting model was the predicted model. Internal locus of control was correlated with medical and legal discourse. The Dominant Drug Discourses Scale appears to measure internalisation of six dominant discourses. The tool has utility in research examining policy development and drug use behaviours. To establish the construct validity of the tool and better understand the constructs being measured, further research is required. [ABSTRACT FROM AUTHOR]

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to explore physical therapy through the stories of physical therapists who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other related identities (LGBTQIA+) to consider how the profession enacts and constructs gender and sexual orientation. Methods: Physical therapists with clinical, academic, and professional roles who identify as LGBTQIA+ were recruited from Australia, the United Kingdom, Canada, and the United States. In-depth data were collected via narrative interviews. An iterative group discourse analysis was used to examine key discourses underpinning interview narratives and how these relate to the physical therapy profession. Results: Twenty-two physical therapists were interviewed. Participants had between 1.5 and 40 years of experience across various clinical areas and settings. Participants identified with varying sexual orientations and gender identities. Analysis identified discourses discussed under the following headings: (1) normativity, which related to hetero-normative assumptions about sexual orientation and cisnormative assumptions about gender identity and the intersectionality among sexual orientation, gender identity, and other forms of marginalization; (2) stress and labor, which explored the stress experienced by physical therapists who are LGBTQIA+ (due to fear of discrimination or actual discrimination) and additional emotional and other types of labor or work done in the workplace to hide aspects of their lives to feel safe, educate colleagues, and be a role model; and (3) professionalism, which related to the heterosexual/cisnormative (and other) "norms" that comprised participants' ideas of presenting as "professional" and positioning physical therapists who are LGBTQIA+ as "unprofessional." Conclusion: Findings suggest that cultural norms may need to be reconceptualized in physical therapy to promote inclusion and belonging of individuals who identify as LGBTQIA+. Approaches to upskill new and existing physical therapists may include elements such as individual and institutional reflexivity, learning and implementing appropriate terminology, displaying indicators of inclusivity, and cultural safety training. These elements may provide the first steps to promote inclusive and culturally safe environments for individuals who identify as LGBTQIA+ within the profession. Impact: This is the first known study to explore the lived experiences of those who identify as LGBTQIA+ in the physical therapy profession. The findings highlight how prevailing normative discourses in Western society are also present in physical therapy and impact those who identify as LGBTQIA+. [ABSTRACT FROM AUTHOR]